By Ronnie Cohen
NEW YORK (Reuters Health) - Few Americans know the signs and symptoms of head and neck cancers, a new study shows.
What’s more, only about one in eight is aware that some of the cancers can be linked to human papillomavirus, or HPV. The sexually transmitted infection is better known for causing cervical cancer in women, but is also behind an increase in the rate of throat cancer, particularly among men.
“Public awareness of head and neck cancer is really, really low, and that is probably harming people because they’re not aware of the risk factors and symptoms,” senior author Dr. Benjamin Judson, from the Yale University School of Medicine in New Haven, Connecticut told Reuters Health.
Head and neck cancers include cancer of the throat, voice box, mouth and tongue. Smoking causes more than 75 percent of the cases in the United States, the authors write in JAMA Otolaryngology–Head and Neck Surgery.
The cancers have been declining overall, the researchers note. But studies show that rates of throat cancer tied to HPV, which can be transmitted through oral sex, tripled between 1988 and 2004.
“It’s an epidemic,” Judson said.
Head and neck cancers account for about three percent of all cancers in U.S. adults.
Head and neck cancer patients, including actor Michael Douglas, who was diagnosed in 2010 with late-stage throat cancer that he attributed to oral sex, tend to seek care after the disease has progressed to advanced stages. In those cases, treatment is more challenging and survival less likely.
“Head and neck cancer is about as common as thyroid cancer and melanoma, but it causes more deaths than the two cancers combined,” Judson said. “If people are aware of the risks and the signs and symptoms, they could be diagnosed earlier.”
He and his colleagues surveyed 2,126 adults to gauge their knowledge of head and neck cancers. The vast majority who completed an online questionnaire knew little or nothing about the tumors or their causes and symptoms, the study found.
Less than one percent of respondents identified HPV as a risk factor for mouth and throat cancer, though in specific questions about 13 percent said they knew of an association between HPV and throat cancer.
Respondents with a college degree were more likely to associate HPV infection with throat cancer; still, less than 15 percent made the connection.
Less than 15 percent of respondents recognized sores that never heal as a symptom of the diseases. Only five percent recognized a sore throat as a symptom and just half a percent saw mouth or throat bleeding as a sign of cancer.
The most common symptoms of throat cancer are voice changes, difficulty swallowing, mouth lesions that don’t heal, neck lumps and mouth sores, speech pathologist Edie Hapner told Reuters Health.
Hapner, from Emory University in Atlanta, was not involved in the current research but has studied public awareness of head and neck cancers.
The lack of public knowledge about the diseases came as no surprise to Hapner.
“The biggest problem is not just the lack of knowledge by the public but by a lot of the medical community,” she said.
In a not-yet-published study, Hapner questioned medical students who had already received training in head and neck cancers and found they felt insufficiently prepared to perform screening exams for head and neck tumors. An hour and a half of training significantly improved the medical students’ confidence and ability, she said.
In a 2013 recommendation, the government-backed U.S. Preventive Services Task Force said there is not enough evidence to determine whether screening people without symptoms for oral cancer has any net benefit.
The annual number of HPV-positive throat cancers is expected to surpass the annual number of cervical cancers by the year 2020, according to a 2011 study in the Journal of Clinical Oncology.
Researchers in 2012 estimated that nearly seven percent of Americans ages 14 to 69 had oral HPV infections. Moreover, HPV rates were as high as 20 percent among people who had more than 20 lifetime sex partners or smoked more than a pack of cigarettes per day.
Two vaccines that reduce the risk of HPV infection and were designed to prevent cervical cancer are available for children and young adults. But researchers do not know if they prevent oral HPV infections, and federal regulators have not approved either vaccine for the prevention of head and neck cancer.
“Unfortunately, we’re going to see more and more people with head and neck cancer,” Judson said. “There’s a need for more public education to raise awareness.”
SOURCE: http://bit.ly/1p2B0GJ JAMA Otolaryngology-Head and Neck Surgery, online June 5, 2014.